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Combined use of alcohol and medicines

Published 12 December 2005. Updated 12 April 2011

Using medicines deliberately to intensify the effect of alcohol increases several risks related to intoxication. But combined use can also occur unintentionally. It can come about, for example, when insomnia caused by large-scale consumption of alcohol is treated with sleeping pills and sedatives. Because the actual affect of medicines lasts much longer than the effect you can feel, the medicine might not have left your system by the time you consume alcohol the next time. The most common form of mixed substance abuse is alcohol and sedatives. Combined use is a somewhat common phenomenon in Finland – it is estimated that one in six drunk drivers test positive for pharmaceuticals or drugs in their blood. Young people have been known to experiment with pharmaceuticals they find at home in the medicine cabinet.

The immediate effects of combined use may be surprising. Among the most common effects are unusually strong intoxication, loss of memory, and behavioural disorders. Loss of memory may lead, for example, to taking an overdose of sleeping pills or sedatives, resulting in a loss of consciousness, mortal danger or, at any rate, a trip to the hospital for stomach pumping. Mixed substance abuse places a terrible burden on the internal organs, sometimes leading to permanent damage.

The joint effect of alcohol and sedatives has even been the cause of some homicides. Regular, combined use of alcohol and sedatives quickly leads to increased tolerance for medicines and addiction. What is more, withdrawal treatment for combined use is much more difficult than alcohol withdrawal. It is typical that after the withdrawal symptoms related to alcohol have passed, the medicine withdrawal symptoms are only beginning. Loss of consciousness and convulsions can still occur weeks later. As withdrawal symptoms become more severe, patients often compulsively search for the medicine they are addicted to. If they can't find it, they will alleviate the symptoms with alcohol or similar medications that they can buy on the street.

A significant number of patients who without warning leave detoxification centres before they have completed treatment have not disclosed a pharmaceutical addiction. . Because the treatment personnel are unaware of the problem, they do not take this factor into account in the treatment plan. As the withdrawal symptoms become more severe, the patient may either use medicines secretly or abandon the treatment. Hence, the vicious circle continues and the patient may face even more serious problems.

Breaking the circle of alcohol and medicine use requires long-term treatment. The best expert is your own doctor. Tell your doctor the whole truth about your alcohol and pharmaceutical use. In some cases, putting an end to pharmaceutical abuse too suddenly may even be fatal, so it is important to adapt a gradual reduction plan. With close monitoring and A-Clinic support, for example, detoxification can succeed. Maintaining total abstinence from alcohol during the treatment is recommended. For more difficult cases, it is a good idea to contact an A-Clinic. For some, detoxification treatment at an institution may be the only feasible route. After institutional care the patient should be monitored by an outpatient clinic, because long-term continued use can cause withdrawal symptoms and other mental problems at a later date. If the problems are not remedied and the patient does not receive the support he or she needs, the symptoms may lead to a new vicious circle of alcohol and/or pharmaceutical abuse.

Antti Holopainen
Chief Physician,
Järvenpää Addiction Hospital

Updated 12 April 2011:
Veli-Matti Surakka
Pharmacist

References

Böström A, Bothas H, Järvinen M, Saarto A, Tamminen H, Teirilä J: Päihdetyö työpaikalla: Lääkkeiden päihde- ja riippuvuuskäyttö, sekakäyttö, 2008.

Keminmaan Raittiustoimisto: Mitä päihteet ovat ja miten ne vaikuttavat?, 2009.

Kuopion Yliopisto: Lääkekasvatus: Alkoholi + lääke, 2009.

Suomalaisen Lääkäriseuran Duodecimin ja Suomen Päihdelääketieteen yhdistyksen asettama työryhmä: Käypä hoito: Alkoholiongelmaisen hoito, 2011.

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